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GDP - Credit Debit Card Auto Debit Form (2020 - 04 - 06 10 - 13 - 00 UTC) PDF
GDP - Credit Debit Card Auto Debit Form (2020 - 04 - 06 10 - 13 - 00 UTC) PDF
GDP - Credit Debit Card Auto Debit Form (2020 - 04 - 06 10 - 13 - 00 UTC) PDF
Card Expiry Date (MM/YYYY) Issue By : Card Type: Credit / Debit / AMEX
Name On Card
1. I authorize Cuckoo to debit my Credit/Debit card account for payment of rental fee(s) under the given rental agreement.
2. The first debit shall commence any time from the data of submission of the authorization form. Subsequent debit will be made in accordance with the
rental agreement frequency as advised by Cuckoo.
3. I shall accept full responsibility for all transactions arising from the use of this Credit/Debit card in payment of rental fee(s).
4. Cuckoo shall not be held responsible or liable for any claims, loss, damage, costs and expenses arising from the successful processing of the debit or
the unsuccessful processing of the debit due to exceeding credit limit, malfunction of system, electricity failure and any other factors beyond the control of
Cuckoo.
5. Cuckoo is only responsible for making arrangement to debit my Credit /Debit card account through the card centre as authorized by me. Therefore, for
any problem or dispute arising from the processing/debiting it will be my own responsibility to resolve it with my Credit/Debit card company.
6. I will ensure that Cuckoo is notified in writing of any changes, loss or replacement of my Credit /Debit card, or cancellation of this authorization at least
one month before the next rental fee(s) due. Such charges or cancellation will become only after Cuckoo has duly acknowledged receipt of such request.
7. Cuckoo may at its absolute discretion at any time terminate this Credit /Debit card debit arrangement without assigning any reason by giving me one
month's notice in writing.
8.Cuckoo reserves the right to change the terms and conditions set out herein at any time or from time to time when circumstances warrant without prior
notice to me.
9. I hereby agree to indemnify and keep Cuckoo indemnified against any claims, loss, damage cost and expenses which Cuckoo may suffer or incur
arising from my authorization to debit my Credit/Debit card account as aforesaid.
10. Rental fees payment that are payable will be considered as paid only upon successful processing of the debit by the card centre.
Name :
NRIC :
Date :